The pressure of performance: erectile dysfunction in younger men

Erectile dysfunction (ED) is commonly associated with elderly men, but in recent years it has emerged that a large proportion of younger men suffer from it too. A 2013 study by Capogrosso revealed that 25% of men seeking treatment for ED were under 40, which highlights that there are other triggers for the condition besides age.

While ED is a sensitive topic whatever your age, there is evidence to suggest that embarrassment may prevent the majority of young sufferers from seeking medical help.

A 2006 anonymous survey by the Chicago Children’s Memorial Hospital, of 234 male students (aged 18-25) at three Chicago universities, revealed that while 13% reported “difficulty getting or keeping an erection,” only 1 of those 29 men had discussed their problem with a doctor. The number of those self-medicating was worryingly much higher, with several men admitting to taking ED medication without a prescription.

So what are the reasons behind young men developing the condition and is it possible to cure?

Physiological or psychological?

There are two main reasons why a man will suffer from ED – a physiological problem (of the body) or a psychological problem (of the mind).

There are several physiological causes for ED. Some are more common in older men, but many can equally affect the young.

Physiological causes:

Obesity

Diabetes

Smoking

Excessive alcohol consumption

Effects of recreational drugs

Serious injury or operations

While alcohol and drugs often have a temporary impact with few lasting effects, obesity and smoking can cause a gradual hardening of the arteries. This requires a change in lifestyle and diet in order to reverse the effects. In many cases, simple lifestyle changes can alleviate the condition, rather than requiring long-term artificial methods.

But erectile dysfunction isn’t always a signal of an underlying medical condition. In some cases it may have a psychological cause.

Psychological causes:

Nerves

Guilt

Relationship difficulties

Depression

Exhaustion

While physiological problems tend to have set methods for treatment, psychological causes often require a more tailored, individualistic approach. You can read up on some of the different psychological treatment options at the bottom of this article.

So how do you tell if the problem is psychological or physiological?

Erectile dysfunction is likely to be psychological if a man can still get an erection from masturbation and often wakes with morning erections, as this demonstrates that the physical functions are in good working order.

However, in many cases ED can have a mixture of physiological and psychological causes, so it’s best to discuss everything with a doctor rather than guessing which treatment will be most suitable.

The problem of porn

You might wonder how porn could be a problem, but back in 2011 Psychology Today published a paper entitled ‘Porn-Induced Sexual Dysfunction is a Growing Problem’ which argued that porn can become addictive and numb your brain’s responses to normal sexual stimuli. This addiction prevents your body from reacting intensely to normal sexual situations, therefore making it harder to get an erection during sex.

How can porn cause poor sexual performance?

Rather than this form of ED stemming from anxiety and therefore being a psychological problem, the cause appears to be physiological, as most men report a similar recovery pattern.

The reason ED occurs is due to porn desensitising the user’s response to the neurochemical dopamine. This chemical is what creates our sense of motivation and wanting – essentially it is what lies behind all addictions and drives the search for rewards. However, addiction researchers have now determined that the more dopamine hits a brain receives, the lower its ability to respond to the signals becomes. Therefore, as with many addictions, a more intense experience is required to achieve the same hit.

While erotica has been around in some form for centuries, it’s the arrival of the internet that’s made it possible for people to achieve the constant stream of dopamine hits required for an addiction to develop. It’s only when men attempt to have normal sex and find erections impossible, that the problem comes to light.

You can read more about the problems, perils and pitfalls of internet porn here.

What treatments are available?

In order to treat this disorder it’s important for the brain to have a chance to withdraw from the addiction and return to normal dopamine sensitivity. This may take one to three months.

Like all addictions, withdrawal can bring on a range of symptoms, from insomnia and irritability, to panic and despair. It may be useful to speak to a counsellor who specialises in addictions if you’re finding it hard to quit.

After a few months you may find that the problem has disappeared completely or there may be a lasting problem of performance anxiety due to the previous failed attempts.

Once dopamine levels have returned to normal, the cycle of failure can sometimes be broken by successful attempts using tablet treatments, or alternatively your doctor may recommend psychological treatment options, such as counselling or psychotherapy.

Ultimately ED can affect any man, no matter what your age, so if you are experiencing ED make sure to talk to a doctor and get a proper prescription for erectile dysfunction treatment, rather than turning to other sources for mystery pills that are likely to do far more harm than good.